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https://www.readbyqxmd.com/read/29458152/controversies-in-endoscopic-eradication-therapy-for-barrett-s-esophagus
#1
Srinadh Komanduri, V Raman Muthusamy, Sachin Wani
Advances in Endoscopic Eradication Therapy for Barrett's Esophagus associated neoplasia have resulted in a significant paradigm shift in diagnosis and management of this complex disease. A robust body of literature critically evaluating outcomes of resection and ablative strategies has allowed gastroenterologists to make quality, evidence based decisions for their patients. Despite this progress, there are still many unanswered questions and challenges that remain. Ultimately, identification of a cost-effective screening modality, biomarkers for risk stratification, and strides to eliminate post surveillance endoscopy after EET are essential to reach our long term goal for eradication of esophageal adenocarcinoma...
February 16, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29456410/split-dose-bowel-preparation-improves-adequacy-of-bowel-preparation-and-gastroenterologists-adherence-to-national-colorectal-cancer-screening-and-surveillance-guidelines
#2
Stacy Bartnik Menees, H Myra Kim, Philip Schoenfeld
AIM: To quantify the impact of split-dose regimen on endoscopists' compliance with guideline recommendations for timing of repeat colonoscopy in patients with normal colonoscopy or 1-2 small polyps (< 10 mm). METHODS: A retrospective chart review of all endoscopy reports was undertaken in average-risk individuals > 50 years old with a normal screening colonoscopy and 1-2 small polyps. Data were abstracted from two time periods, pre and post-split-dose bowel preparation institution...
February 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29453383/hyperbaric-oxygen-therapy-is-well-tolerated-and-effective-for-ulcerative-colitis-patients-hospitalized-for-moderate-severe-flares-a-phase-2a-pilot-multi-center-randomized-double-blind-sham-controlled-trial
#3
Parambir S Dulai, Jay C Buckey, Laura E Raffals, Jason M Swoger, Paul L Claus, Kevin O'Toole, Judy A Ptak, Michael W Gleeson, Christella E Widjaja, John T Chang, Jeffery M Adler, Nihal Patel, Laurie A Skinner, Shawn P Haren, Kimberly Goldby-Reffner, Kimberly D Thompson, Corey A Siegel
BACKGROUND: Hyperbaric oxygen therapy (HBOT) markedly increases tissue oxygen delivery. Case series suggest it may have a potential therapeutic benefit in ulcerative colitis (UC). We investigated the therapeutic potential of HBOT as an adjunct to steroids for UC flares requiring hospitalization. METHODS: The study was terminated early due to poor recruitment with 18 of the planned 70 patients enrolled. UC patients hospitalized for moderate-severe flares (Mayo score ≥6, endoscopic sub-score ≥2) were block randomized to steroids + daily HBOT (n = 10) or steroids + daily sham hyperbaric air (n = 8)...
February 16, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29451515/-promoting-evidence-based-gastroenterology-back-to-the-future
#4
Maurizio Koch
Evidence-based medicine continues to thrive thanks to the publication of a considerable amount of papers focusing on data collection and sharing. Assessment of the accuracy of diagnostic tests still remains highly deficient, often leading to inappropriate clinical decision-making. Like most other doctors, gastroenterologists as well have to face the ever-growing availability of complex and expensive exams, being charged with the task of choosing the best diagnostic option and interpreting test results. It is therefore advisable to provide specialists with the tools they need to evaluate the available literature data...
January 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29449789/factors-associated-with-prescribing-costs-analysis-of-a-nationwide-administrative-database
#5
O Hirsch, M Schulz, M Erhart, N Donner-Banzhoff
Objective: All health care systems in the world struggle with rising costs for drugs. We sought to explore factors impacting on prescribing costs in a nationwide database of ambulatory care in Germany. Factors identified by this research can be used for adjustment in future profiling efforts. Methods: We analysed nationwide prescription data of physicians having contractual relationships with statutory health insurance funds in 2014. Predictor and outcome variables were aggregated at the practice level...
2018: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/29444547/laparoscopic-surgery-with-urinary-tract-reconstruction-and-bowel-endometriosis-resection-for-deep-infiltrating-endometriosis
#6
REVIEW
Yoshiaki Ota, Masaaki Andou, Ikuko Ota
Deep infiltrating endometriosis (DIE) is the most severe form of endometriosis. It causes chronic pelvic pain, severe dysmenorrhea, deep dyspareunia, dyschezia, and dysuria, markedly impairing the quality of life of women of reproductive age. A number of randomized controlled trials on surgical and medical treatments to reduce the pain associated with endometriosis have been reported, but few have focused on this in DIE. DIE causes not only pain but also functional invasion to the urinary organs and bowel, such as hydronephrosis and bowel stenosis...
February 14, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29441683/cardiovascular-safety-of-prokinetic-agents-a-focus-on-drug-induced-arrhythmias
#7
REVIEW
J R Giudicessi, M J Ackerman, M Camilleri
BACKGROUND: Gastrointestinal sensorimotor dysfunction underlies a wide range of esophageal, gastric, and intestinal motility and functional disorders that collectively constitute nearly half of all referrals to gastroenterologists. As a result, substantial effort has been dedicated toward the development of prokinetic agents intended to augment or restore normal gastrointestinal motility. However, the use of several clinically efficacious gastroprokinetic agents, such as cisapride, domperidone, erythromycin, and tegaserod, is associated with unfavorable cardiovascular safety profiles, leading to restrictions in their use...
February 14, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29436213/gastric-reflux-comparison-between-the-gastroenterologist-and-the-otorhinolaryngologist%C3%A2-s-approach-pragmatic-conclusive-remarks
#8
G Ciprandi, M Gelardi
Gastroesophageal reflux (GER) is a normal physiological process that usually happens after eating in healthy infants, children, young people and adults. In contrast, gastroesophageal reflux disease (GERD) occurs when the effect of GER leads to symptoms severe enough to merit medical treatment. In clinical practice, it is difficult to differentiate between GER and GERD, and health professionals and families use the terms interchangeably alike. There is no simple, reliable and accurate diagnostic test to confirm whether the condition is GER or GERD, and this in turn affects research and clinical decisions (1-6)...
January 2018: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29436209/focus-on-gastroesophageal-reflux-ger-and-laryngopharyngeal-reflux-lpr-new-pragmatic-insights-in-clinical-practice
#9
M Gelardi, G Ciprandi
Gastroesophageal reflux (GER) is a common disease usually limited to the oesophagus. Laryngopharyngeal reflux (LPR) is an inflammatory reaction of the mucosa of pharynx, larynx, and other associated upper respiratory organs, caused by a reflux of stomach contents outside the oesophagus. LPR is considered to be a relatively new clinical entity with a vast number of clinical manifestations which are treated sometimes empirically and without a correct diagnosis. However, there is disagreement between specialists about its definition and management: gastroenterologists consider LPR to be a substantially rare manifestation of gastroesophageal reflux disease (GERD), whereas otolaryngologists believe that LPR is an independent, but common in their practice, disorder...
January 2018: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29433829/acute-mesenteric-ischemia-a-critical-role-for-the-radiologist
#10
P Copin, M Zins, A Nuzzo, Y Purcell, S Beranger-Gibert, L Maggiori, O Corcos, V Vilgrain, M Ronot
Acute mesenteric ischemia is defined as an inadequate blood supply to the gastrointestinal tract resulting in ischemic and inflammatory injury that may progress to necrosis of the bowel wall. Prognosis is poor with a mortality rate greater than 95% without treatment, dropping to around 70% when surgical treatment is performed. Contrast-enhanced computed tomography (CT) has become the cornerstone of the diagnosis by showing features of vascular disorders (occlusion and/or insufficient blood supply) and features of intestinal ischemic injury...
February 9, 2018: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/29432922/use-of-appropriate-surveillance-for-patients-with-non-dysplastic-barrett-s-esophagus
#11
Anna Tavakkoli, Henry D Appelman, David G Beer, Chaitra Madiyal, Maryam Khodadost, Kimberly Nofz, Val Metko, Grace Elta, Thomas Wang, Joel H Rubenstein
BACKGROUND & AIMS: Barrett's Esophagus (BE) is a precursor to esophageal adenocarcinoma (EAC). Guidelines recommend that patients with nondysplastic BE (NDBE) undergo surveillance endoscopy every 3-5 years. We aimed to identify factors associated with surveillance endoscopy of patients with NDBE and identify trends in appropriate surveillance endoscopy of NDBE at a large tertiary care center. METHODS: We performed a retrospective analysis of data from a Barrett's Esophagus Registry, identifying patients with NDBE who underwent endoscopy in 2002 or later...
February 9, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29429768/are-senna-based-laxatives-safe-when-used-as-long-term-treatment-for-constipation-in-children
#12
Alejandra Vilanova-Sanchez, Alessandra C Gasior, Nicole Toocheck, Laura Weaver, Richard J Wood, Carlos A Reck, Andrea Wagner, Erin Hoover, Renae Gagnon, Jordon Jaggers, Tassiana Maloof, Onnalisa Nash, Charae Williams, Marc A Levitt
BACKGROUND AND AIM: Senna is a stimulant laxative commonly used by pediatricians, pediatric gastroenterologists, and pediatric surgeons. Many clinicians avoid Senna for reasons such as tolerance or side effects but this has little scientific justification. We recently found several patients we were caring for developed perineal blistering during the course of Senna treatment. Because of this we chose to review the literature to identify side effects in children taking this medication as well as to analyze our Center's experience with Senna's secondary effects...
January 31, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29429156/guideline-adherence-to-colonoscopic-surveillance-intervals-after-polypectomy-in-korea-results-from-a-nationwide-survey
#13
Seri Hong, Mina Suh, Kui Son Choi, Boyoung Park, Jae Myung Cha, Hyun-Soo Kim, Jae Kwan Jun, Dong Soo Han
Background/Aims: People around the world are increasingly choosing to undergo colorectal cancer screening via colonoscopy. As a result, guideline adherence to postpolypectomy colonoscopy surveillance has drawn increasing attention. The present study was performed to assess recognition and adherence to guidelines among primary care physicians and gastroenterologists and to identify characteristics associated with compliance. Methods: A nationwide sample of primary care physicians employed at cancer screening facilities and registered members of the Korean Society of Gastrointestinal Endoscopy were recruited...
February 13, 2018: Gut and Liver
https://www.readbyqxmd.com/read/29427733/extraesophageal-symptoms-and-diseases-attributed-to-gerd-where-is-the-pendulum-swinging-now
#14
Michael F Vaezi, David Katzka, Frank Zerbib
BACKGROUND AND AIMS: The purpose of this review is to outline the recent developments in the field of extraesophageal reflux disease and provide clinically relevant recommendations. METHODS: The recommendations outlined in this review are based on expert opinion and on relevant publications from PubMed and EMbase. The Clinical Practice Updates Committee of the American Gastroenterological Association proposes the following recommendations: 1. The role of a gastroenterologist in patients referred for evaluation of suspected extra esophageal symptom is to assess for gastroesophageal etiologies that could contribute to the presenting symptoms...
February 7, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29427486/management-of-patients-with-non-alcoholic-steatohepatitis-nash-in-real-life
#15
REVIEW
Lawrence Serfaty
Non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) is a prevalent condition that is associated with the development of cirrhosis and hepatocellular carcinoma and with no approved treatment options except for lifestyle changes. Guidelines have been drafted for the management of NAFLD patients in this setting. Because of the lack of real-life cohort data, we will focus on practice surveys on the management of patients with NAFLD/NASH, which included primary care practitioners, gastroenterologists/hepatologists and other specialists from various countries...
February 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29426057/inflammatory-bowel-disease-and-clostridium-difficile-infection-contrasting-views-of-international-clinical-professionals
#16
Andreas Stallmach, Veli-Jukka Anttila, Markus Hell, Simon Gwynn, Paloma Merino-Amador, Nicola Petrosillo, Zdenek Ráčil, Tim Warren, Christoph Wenisch, Mark Wilcox
INTRODUCTION:  In patients with inflammatory bowel disease (IBD), Clostridium difficile infection (CDI) is a risk factor for both morbidity and mortality. Currently, appropriate management is unclear. Guidance on best practice in the diagnosis and treatment of CDI in IBD patients is therefore needed. METHODS:  A multidisciplinary group of clinicians involved in the treatment of patients with IBD and CDI developed 27 consensus statements. Respondents were asked to rate their agreement with each statement using a 4-point Likert scale...
February 9, 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29425781/single-fluid-filled-intragastric-balloon-safe-and-effective-for-inducing-weight-loss-in-a-real-world-population
#17
Eric J Vargas, Carl M Pesta, Ahmad Bali, Eric Ibegbu, Fateh Bazerbachi, Rachel L Moore, Vivek Kumbhari, Reem Z Sharaiha, Trace W Curry, Gina DosSantos, Ramsey Schmitz, Abhishek Agnihotri, Aleksey A Novikov, Tracy Pitt, Margo K Dunlap, Andrea Herr, Louis Aronne, Erin Ledonne, Hoda C Kadouh, Lawrence J Cheskin, Manpreet S Mundi, Andres Acosta, Christopher J Gostout, Barham K Abu Dayyeh
BACKGROUND & AIMS: The Orbera Intragastric Balloon (OIB) is a single fluid-filled intra-gastric balloon approved for induction of weight loss and treatment of obesity. However, little is known about the effectiveness and safety of outside clinical trials, and since approval, the Food and Drug Administration has issued warnings to healthcare providers about risk of balloon hyper-inflation requiring early removal, pancreatitis, and death. We analyzed data on patients who have received the OIB since its approval determine its safety, effectiveness, and tolerance in real-world clinical settings...
February 6, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29423559/mind-the-gap-results-of-a-multispecialty-survey-on-coordination-of-care-for-peri-procedural-anticoagulation
#18
Jacob E Kurlander, Geoffrey D Barnes, Michelle A Anderson, Brian Haymart, Eva Kline-Rogers, Scott Kaatz, Sameer D Saini, Sarah L Krein, Caroline R Richardson, James B Froehlich
To understand how physicians from various specialties perceive coordination of care when managing peri-procedural anticoagulation. Cross-sectional survey of cardiologists, gastroenterologists, and primary care physicians (PCPs) in an integrated health system (N = 251). The survey began with a vignette of a patient with atrial fibrillation co-managed by his PCP, cardiologist, and an anticoagulation clinic who must hold warfarin for a colonoscopy. Respondents' experiences and opinions around responsibilities and institutional support for managing peri-procedural anticoagulation were elicited using multiple choice questions...
February 8, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29422797/quality-is-the-key-for-emerging-issues-of-population-based-colonoscopy-screening
#19
REVIEW
Jin Young Yoon, Jae Myung Cha, Yoon Tae Jeen
Colonoscopy is currently regarded as the gold standard and preferred method of screening for colorectal cancer (CRC). However, the benefit of colonoscopy screening may be blunted by low participation rates in population-based screening programs. Harmful effects of population-based colonoscopy screening may include complications induced by colonoscopy itself and by sedation, psychosocial distress, potential over-diagnosis, and socioeconomic burden. In addition, harmful effects of colonoscopy may increase with age and comorbidities...
January 2018: Intestinal Research
https://www.readbyqxmd.com/read/29415338/a-statewide-program-providing-colorectal-cancer-screening-to-the-uninsured-of-south-carolina
#20
Jan M Eberth, Annie Thibault, Renay Caldwell, Michele J Josey, Beidi Qiang, Edsel Peña, Delecia LaFrance, Franklin G Berger
BACKGROUND: Cancer screening rates are lowest in those without insurance or a regular provider. Since 2008, the Colorectal Cancer Prevention Network (CCPN) has provided open access colonoscopy to uninsured residents of South Carolina through established, statewide partnerships and patient navigation. Herein, we describe the structure, implementation, and clinical outcomes of this program. METHODS: The CCPN provides access to colonoscopy screening at no cost to uninsured, asymptomatic patients aged 50-64 years (African Americans age 45-64 years are eligible) who live at or below 150% of the poverty line and seek medical care in free medical clinics, federally qualified health centers, or hospital-based indigent practices in South Carolina...
February 7, 2018: Cancer
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